Contact Codes for ENG

Question

Answer

All of the vestibular codes, with the exception of 92543, are contact codes. That means that regardless of how many times the clinician performs the procedure on the same date of service, the code is reported and billed only one time. For example, the positional nystagmus procedure (CPT code 92542) has a complete descriptor as follows: "Positional nystagmus test, minimum of 4 positions, with recording." This means that at least four positions are necessary before the clinician can be qualified to report and bill this code. CPT code 92543, as the exception to the one time per date of service rule, is reported for each irrigation to a maximum of four irrigations which means that this code can be billed either four times or four units. This declaration for 92543 was made by Medicare and is found in the Federal Register and on the Medicare website www.cms.hhs.gov/ All other vestibular codes, including 92546, are to be billed only one time per date of service. Each of these codes is valued based on the median time necessary to complete all aspects of a given protocol. This valuation process forms the basis of the rationale to bill each code one time, again with the exception of 92543 which can be billed up to four times per date of service.

Robert C.Fifer, Ph.D. is currently the Director of Audiology and Speech-Language Pathology at the Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine. He is a member of ASHA's Health Care Economics Committee and the ASHA representative to the American Medical Association's Health Care Professions Advisory Committee for the Relative Value Utilization Committee in addition to being ASHA's representative to the AMA's Practice Expense Review Committee.